Healthcare Provider Details

I. General information

NPI: 1336947167
Provider Name (Legal Business Name): BAXTER COUNTY REGIONAL HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2025
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1019 E MAIN ST
MELBOURNE AR
72556-8240
US

IV. Provider business mailing address

1019 E MAIN ST
MELBOURNE AR
72556-8240
US

V. Phone/Fax

Practice location:
  • Phone: 870-916-2150
  • Fax: 870-916-2012
Mailing address:
  • Phone: 870-916-2150
  • Fax: 870-916-2012

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DEBRA HENRY
Title or Position: AO
Credential:
Phone: 870-508-1003